Abstract
Objective: To compare the values of exophthalmos measured by computed tomography (CT) and Hertel exophthalmometry (HE) in patients with thyroid-associated ophthalmopathy (TAO). Material and Methods: One hundred and seventy eyes were examined in 85 patients with TAO. Each patient underwent a complete ophthalmic examination, Hertel exophthalmometry, and CT of the orbits through a 16-slice CT scanner (Bright Speed, General Electric), measuring the extraocular muscles, the total muscle thickness sum (MTS), and proptosis. The patients were divided into two groups-with activity and without TAO activity, the activity being assessed by means of the Clinical Activity Score (CAS) and the severity-according to the EUGOGO classification. Results: TAO activity was detected in 45 patients (90 eyes, 53%) with MTS of 23.54 ± 5.73 mm, IOP of 19.78 ± 4.49 mm Hg, Hertel exophthalmos of 23.08 ± 4.19 mm and measured by CT-23.32 ± 4.33 mm. Forty patients (80 eyes, 47%) were without TAO activity, with MTS of 19.28 ± 4.03, IOP of 16.6 ± 4.51 mm Hg, Hertel exophthalmos of 20.03 ± 3.84 mm and measured by CT-19.84 ± 4.47 mm. A correlation was detected between exophthalmos and: MTS, IOP, the activity and severity of TАО. High congruence was established between the two methods of measuring exophthalmos-CT and HE (Pearson correlation, r = 0.690, p = 0.000). Conclusion: Our results showed a high degree of consistency between Hertel exophthalmometry and multidetector CT for the evaluation of exophthalmos in patients with TAO. Exophthalmos is an important clinical feature and its measurement and monitoring over time assess the clinical course and outcome of treatment.
Highlights
Thyroid-associated ophthalmopathy is the most common extrathyroidal manifestation of Graves’ disease and the hyperthyroidism related to it
To compare the values of exophthalmos measured by computed tomography (CT) and Hertel exophthalmometry (HE) in patients with thyroid-associated ophthalmopathy (TAO)
The patients were divided into two groups—with activity and without TAO activity, the activity being assessed by means of the Clinical Activity Score (CAS) and the severity—according to the EUGOGO classification
Summary
Thyroid-associated ophthalmopathy is the most common extrathyroidal manifestation of Graves’ disease and the hyperthyroidism related to it. In rare cases, it is observed in patients with Hashimoto’s thyroiditis, hypothyroidism or euthyroidism [1]. TAO is a chronic autoimmune process against orbital antigens, in which lymphocytic infiltration, fibroblast proliferation and adipogenesis develop, along with the accumulation of glucosaminoglycans in the tissues of the orbit and an increase in their volume, with typical fusiform thickening of the extraocular muscles and the eyeball being pushed forward as a sign of spontaneous decompression. The clinical manifestations of TAO include eyelid retraction, exophthalmos, edema and hyperemia of the eyelids and conjunctiva, pain in the orbits, as well as eye movement pain and low vision
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
